NURS13143: Digital Health, Technology, and Informatics

This assessment relates to the video ‘ Australian College of Rural and Remote Medicine (ACRRM) Telehealth Case Study-Emerald, North Queensland.’

https://www.youtube.com/watch?v=XUwpu91MwQA&list=PL0OijzDDBQuaZXpycVJyFvh89nTV5AN0R&index=3

This video provides a positive account of the use of telehealth, while also referring to some of the challenges that healthcare professionals need to overcome to use such technology. The case study is specifically related to telehealth for rural/remote locations.

The assessment consists of three sections, which you will explore and discuss.

Section One

Choose three benefits or advantages of telehealth that were discussed in the video. These should specifically relate to people living in rural and remote areas. Discuss these using relevant current literature to support your argument (500 words).

Three benefits or advantages of telehealth:

Cost effective remote care

Telehealth or telemedicine offers numerous benefits for both patients and healthcare providers. The involvement of telehealth in healthcare allows rural patients to consult with healthcare providers without the need to travel long distances to urban medical facilities (Shah et al., 2020). This is especially significant in areas with limited public transportation options or harsh weather conditions. In rural areas where hospitals may not be as accessible, patients need to travel to the nearby hospital or in an emergency situation have to wait for the arrival of an ambulance and the transport all the way to the hospital. However, the involvement of telehealth provides additional comfort with the ability for remote care (Hahn et al., 2023). The cost associated with travelling for medical care places an additional burden on the patient, including incurring additional costs for travelling to visits, lost work hours, lower productivity, and increased costs associated with arranged care (Gajarawala & Pelkowski, 2021). However, telehealth services can save time and money and thereby create an option for cost effective remote care for patients with less additional health burden (Evers et al., 2022).

Improve access to care

Residents of rural communities across Australia include some of the vulnerable populations, including individuals with low socioeconomic status. Rural areas typically have a shortage of specialists; telehealth can connect patients with specialists located in urban or distant areas, ensuring that they receive specialized care without travelling long distances (Australian Government, 2022). Healthcare services like primary care, specialized care, and mental healthcare are often less common in sparsely populated areas. With the help of telehealth people living in rural areas can access care beyond what may be in a scope for primary care providers (PCPs), including various aspects of clinical specialties such as cardiology, dermatology, and even emergency medicine. Telehealth enables PCPs to collaborate with specialists located in urban areas to consult and get access to expert opinions even from remotely (Gajarawala & Pelkowski, 2021).

Improved family engagement

Telehealth has the potential to significantly improve communication between patients and their families. Some families may feel more comfortable discussing sensitive or personal issues in the privacy of their own home. Families facing stigmatized issues, such as mental health concerns or relationship problems, may be more inclined to seek help through telehealth because it can offer a level of community. Telehealth enables patients and their families to participate in virtual appointments from the comfort of their homes (Haleem et al., 2021). These direct video interactions allow for real-time communication with healthcare providers, fostering a more personal and interactive experience. Families living in rural areas face barriers related to transportation and geographical distance to access consultation at healthcare centres. However, the involvement of telehealth makes the consultation process more convenient for patients and their families (Gajarawala & Pelkowski, 2021). Telehealth appointments can be scheduled at times that are easily accessible for the patient and their families, accommodating work and other commitments. Family members can improve communication with healthcare providers by using telehealth platforms like secure messaging and phone calls. These features can allow the families to ask questions regarding the patient's health, request prescription refills, and receive updates or clarifications from healthcare providers (Queensland Government, 2021). Also, the healthcare provider can use telehealth to educate patients' families by using virtual sessions to explain treatment plans, discuss medical conditions, and offer guidance on managing health issues (Butzner & Cuffee, 2021).

Section Two

Discuss three challenges or barriers to telehealth in a small rural or remote community; one of these points must be around cybersecurity, privacy and/or electronic exchange of information. Use relevant current literature to support your argument (500 words).

Technology factors

Technology plays a significant role in the effectiveness, accessibility, and usability of telehealth. However, small rural or remote communities may lack robust technologies like internet infrastructure, digital devices, and telehealth equipment availability (Gajarawala & Pelkowski, 2021). Houser et al (2023) in their study reported technology factors and digital literacy as the barrier to telehealth. People living in rural areas have limited or unreliable internet connectivity, which can hinder the use of telehealth. Factors like slow internet speeds or frequent disconnections can disrupt telehealth consultations, making it difficult for healthcare providers and patients to communicate effectively. The limited access of the rural population to the necessary technology like smartphones and computers can also limit the adoption of telehealth in rural areas (Gajarawala & Pelkowski, 2021). Also, remote areas have lack of telehealth platforms and appropriate telehealth equipment's like high-quality cameras and microphones. Insufficient or outdated equipments can affect the quality of telehealth consultations (Haque et al., 2021). Power and electrical issues is another significant barrier which affects the continuity of care through telehealth. They may experience power outages or fluctuations more frequently than urban areas. Not having reliable power sources like battery-powered telehealth equipment is a barrier to joining telehealth sessions on time (Houser et al.,2023).

Cybersecurity risk

The increased use of telehealth in healthcare also increases cybersecurity risk. Telehealth sessions involve the transmission of sensitive medical information including personal identifying information, medical history, and other confidential data over the internet or other electronic networks (Houser et al., 2023). Recently, data breaches of patients have been reported as the main cybersecurity risk associated with telemedicine (Gajarawala & Pelkowski, 2021). By using malware or malicious software cybercriminals can gain untheorized access to steal personal information of patients or disrupt telemedicine sessions. If this information falls into the wrong hands, it can be used for fraudulent purposes or identity theft. Many telehealth providers use third-party vendors or cloud services to host or manage patient data. By faking their identity cybercriminals can act like third-party vendors and can use phishing emails or messages to trick healthcare providers or patients into disclosing sensitive information, also compromising patient privacy (Das et al., 2022). This promotes cyber security vulnerability by increasing the risk that inadequate data encryption transmitted during telehealth consultation can lead to data interception by unauthorized individuals (Gajarawala & Pelkowski, 2021).

Lack of operational cost

Some of the organizational factors like reimbursement and funding, can affect the implication and success of telehealth in rural areas (Gajarawala & Pelkowski, 2021). Rural healthcare facilities often operate with limited budgets and without proper reimbursement, rural providers may struggle to cover the costs of implementing and maintaining telehealth technology. This affects the accessibility to receive care promptly. Moreover, poorly planned implementation can disrupt the clinical process, affecting patient care and provider efficiency. Inadequate funds and installation cost to rural health care providers can lead to suboptimal utilization and challenges in delivering high-quality telehealth care for target population (Haque et al., 2021). The government need to initiate funds for better operational benefits.

Section Three

Discuss how telehealth technology supports person-centred care. Consider implications for delivering person-centred care in small rural and remote locations/towns.

Telehealth allows to deliver person person-centred care by prioritizing individual needs, preferences, and involvements in their healthcare decisions. With the rise of telehealth to deliver patient-centred care, people living in rural areas are more capable of accessing healthcare services regardless of their locations. Telehealth's increased accessibility empowers patients to seek care as per their needs and preferences (Aghdam et al., 2019). The telehealth sessions with the specialists supports the patients and their family’s engagement in the treatment and arranged care plan. The ongoing communication of patients with healthcare providers allows them to identify the needs and preferences of patients to tailor treatment plans based on real-time information. Telehealth enables the continuity of care by eliminating geographical barriers, allowing families to access consultancy services and support when they need it most.

(Australian Government, 2022).

Telehealth supports person-centred care by involving multidisciplinary teams (MDT). Aghdam et al (2019) in their study stated that the use of telemedicine provides important advantages in the provision of MDT meetings. The role of MDT is found to be necessary for safe diagnosis, treatment, and follow-ups. People living in rural areas face difficulties in regularly visiting healthcare settings for regular checkups and take specialized care. However, telehealth bridges this gap by allowing the MDT to collaborate virtually with the patient or the PCPs available in rural areas. For instance, telehealth connects mental health professionals, therapists, and counsellors with the primary care team in rural areas. The collaborative efforts of the MDT and primary care team help to address both physical and mental health aspects, promoting person-centred care (Aghdam et al., 2019) Telemedicine MDT has also been shown to be time-adequate, reduce overtime, build a stable competence network, and increase expertise. For instance, through telehealth virtual sessions a dietician can provide nutritional guidance, a physical therapist can demonstrate exercise, and a nurse can offer information about the patient’s current health status (Aghdam et al., 2019).

Telehealth promotes the effectiveness of the treatment provided by promoting communication, educating patients and maintaining cultural sensitivity, which ultimately leads to facilitating personalized care. Telehealth technology supports the delivery of educational material like videos and infographics and consultation with specialists (Hitly et al., 2020). This empowers the patients to gain information about their conditions by improving heath literacy. Through telehealth consultancy, the healthcare provider can ensure that care is respectful and culturally sensitive. In rural areas people used to follow different cultural beliefs according to their communities and tribes (Record et al., 2021). Telehealth allows the healthcare worker to communicate effectively with patients who speak different languages or have diverse cultural backgrounds. The platforms available in telehealth services can offer interpretation services allowing patients and healthcare providers to overcome language barriers and communicate effectively to identify patient-centered needs (Hitly et al., 2020).

References

Aghdam, M. R. F., Vodovnik, A., & Hameed, R. A. (2019). Role of telemedicine in multidisciplinary team meetings.  Journal of Pathology Informatics ,  10 (1), 35. https://doi.org/10.4103%2Fjpi.jpi_20_19

Australian Government. (2022). Telehealth. https://www.health.gov.au/topics/health-technologies-and-digital-health/about/telehealth

Butzner, M., & Cuffee, Y. (2021). Telehealth interventions and outcomes across rural communities in the United States: narrative review.  Journal of Medical Internet Research ,  23 (8), e29575. https://doi.org/10.2196%2F29575

Das, S., Madathil, K., Dykstra, J., Rajivan, P., Setty, S., McElligott, J. T., ... & Votipka, D. (2022, September). Privacy and Security of Telehealth Services. In  Proceedings of the Human Factors and Ergonomics Society Annual Meeting . 66(1), 1524-1528. https://doi.org/10.1177/1071181322661032

Evers, E. C., Fritz, S. A., Colditz, G. A., & Burnham, J. P. (2022). Perceptions of telemedicine and costs incurred by a visit to a general infectious diseases clinic: a survey. In  Open Forum Infectious Diseases . 9(3), 661. https://doi.org/10.1093%2Fofid%2Fofab661

Gajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth benefits and barriers.  The Journal for Nurse Practitioners ,  17 (2), 218-221. https://doi.org/10.1016%2Fj.nurpra.2020.09.013

Hahn, Z., Hotchkiss, J., Atwood, C., Smith, C., Totten, A., Boudreau, E., ... & Sarmiento, K. (2023). Travel burden as a measure of healthcare access and the impact of telehealth within the veterans health administration.  Journal of General Internal Medicine , 1-9. https://doi.org/10.1007/s11606-023-08125-3

Haleem, A., Javaid, M., Singh, R. P., & Suman, R. (2021). Telemedicine for healthcare: Capabilities, features, barriers, and applications.  Sensors international ,  2 , 100117. https://doi.org/10.1016%2Fj.sintl.2021.100117

Haque, S. N., DeStefano, S., Banger, A., Rutledge, R., & Romaire, M. (2021). Factors influencing telehealth implementation and use in frontier critical access hospitals: qualitative study.  JMIR Formative Research ,  5 (5), 24118. https://doi.org/10.2196%2F24118  

Hilty, D. M., Gentry, M. T., McKean, A. J., Cowan, K. E., Lim, R. F., & Lu, F. G. (2020). Telehealth for rural diverse populations: telebehavioral and cultural competencies, clinical outcomes and administrative approaches.  Mhealth ,  6 .20. https://doi.org/10.21037%2Fmhealth.2019.10.04

Houser, S. H., Flite, C. A., & Foster, S. L. (2023). Privacy and Security Risk Factors Related to Telehealth Services–A Systematic Review.  Perspectives in Health Information Management ,  20 (1). https://pubmed.ncbi.nlm.nih.gov/37215337

Queensland Government. (2021). Digital strategy for rural and remote healthcare. https://www.health.qld.gov.au/__data/assets/pdf_file/0018/1141713/digital-strategy-for-rural-and-remote-healthcare.pdf

Record, J. D., Ziegelstein, R. C., Christmas, C., Rand, C. S., & Hanyok, L. A. (2021). Delivering personalized care at a distance: how telemedicine can foster getting to know the patient as a person.  Journal of Personalized Medicine ,  11 (2), 137. https://doi.org/10.3390/jpm11020137

Shah, S., Erinjeri, J., Guan, Q. X., Otto, C., & Solomon, S. B. (2020). Telemedicine visits reduce time to biopsy, travel time and costs for interventional radiology patients. https://ascopubs.org/doi/abs/10.1200/JCO.2020.38.15_suppl.2082